Treatment of pemphigus vulgaris. Results obtained in 84 patients between 1961 and 1982

A review of the treatment of 84 patients with pemphigus vulgaris between 1961 and 1982 showed that 47 of the 84 patients were free of lesions and not receiving treatment as of Jan 1, 1983. Twenty-two of the patients had been without lesions and treatment for more than five years. There had been no disease- or treatment-related fatalities since 1976. Two types of treatment have been used in recent years: in severe cases an initial course of large daily doses of prednisone (200 to 400 mg) was given for six to ten weeks. This was followed by combined treatment with small, alternate-day doses of prednisone plus a daily dose of an immunosuppressant agent, usually azathioprine. In mild, relatively stable cases the combined form of treatment was given from the beginning. The use of intermediate doses of prednisone, ie, doses between 40 mg every other day and 200 mg/day, is discouraged as potentially hazardous.